Posts

4 Strategies to Optimize Revenue Cycle in Healthcare and Mitigate Losses

November 24, 2020/12500 views / 0 Comments/in BLOG, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

The US healthcare system has been going through a rough patch for a number of years now. When one problem is solved, other critical issues arise. However, with all these preexisting issues, it is now facing its biggest challenge in decades: COVID-19. With patients postponing regular visits and elective procedures, COVID-19 has created a severe financial strain and plunged hospitals and health systems into unprecedented losses. While hospitals are having to cope with these losses by closing down emergency departments, laying off employees, and so on, they can significantly reduce costs by focusing on their revenue cycles. Let’s explore why revenue cycle in healthcare is crucial, some strategies to optimize it, and how positive patient identification can help significantly.

Why is revenue cycle in healthcare important?

Revenue cycle management is one of the most crucial aspects of any given healthcare provider. In a nutshell, it is the series of events that starts when a patient schedules an appointment and ends when the provider receives payment and is reimbursed. Since it’s related to patient service revenue, it has a direct effect on any hospital’s bottom line.

If a hospital’s revenue cycle is optimized, then it will face higher margins, and if not, it will face significant losses. Complications such as billing and coding errors, patient misidentification at the front-end, and miscommunication lead to denied claims and delayed payments. In the end, patient volume won’t matter if a hospital takes a long time to capture the revenue or faces denied claims. Thus, optimized revenue cycle in healthcare facilities is extremely important if hospitals want to continue to operate in the foreseeable future.

4 Strategies to optimize revenue cycle management

Improve front-end and back-end collaboration

The front-end consists of activities where the hospital’s staff members interact with the patient directly: patient information collection, appointment scheduling, eligibility, verifying insurance coverage, upfront patient collections, and registration of new patients are just a few examples.

The back-end, on the other hand, consists of medical billing, claims management, denials management, as well as the collection of final “patient financial responsibility”.

Usually, when it comes to revenue cycle management, most healthcare providers have their front-end and back-end tasks separated. However, collaboration between the two can significantly improve revenue cycle management. Effective and seamless communication is the key, and if that can be facilitated between the front-end and back-end teams, then it will result in faster, more accurate, and improved collections.

Improve front-end activities

According to a recent webinar, half of denied claims incurred by hospitals can be traced back to front-end activities, with the top contributors being registration and eligibility issues. These ultimately cause issues at the back-end of the revenue cycle in healthcare facilities, and the caregivers are forced to allocate significant resources such as FTEs (full-time equivalents) to fix billing and coding errors. If the front-end issues are not addressed, then this will lead to an endless cycle of lower productivity and an unoptimized revenue cycle.

If the front-end processes can be improved by preventing common errors such as patient misidentification or missing patient information, then issues like claim denials, underpayments, and lower productivity of the FTEs can be vastly reduced. Automating the front-end workflow is just one step towards improvement – but more on that later.

Adopt revenue cycle automation

Revenue cycle automation is becoming more popular within the healthcare space, and for good reason. It leads to a significant reduction in the pressure that is put on healthcare professionals, reduces avoidable errors, and streamlines the entire process. However, organizations have to be cautious in their search for an effective automation tool.

Identify patients accurately

The most prominent issues that cause revenue cycle inefficiencies are patient identification errors, duplicate medical records, and medical record mix-ups at the front-end. If the accurate medical record isn’t identified, then the subsequent processes will be riddled with errors, leading to denied claims. Hospitals lose a huge amount of money – around $4.9 million – due to denied claims, many of which can be traced back to patient identification errors. Thus, revenue cycle in healthcare can be optimized if patient misidentification, duplicates, and mix-ups can be eliminated. This is exactly what RightPatient does.

RightPatient is a touchless patient identification platform that is used by several healthcare providers. It uses the patients’ photos to verify their identities, eliminating misidentification, avoiding duplicates, and preventing mix-ups at the front-end.

New patients need to take a photo during registration, locking their medical records with it. Enrolled patients only need to look at the camera – the platform identifies the patients accurately by matching the photos and provides the appropriate medical records within seconds.

By eliminating misidentification, mix-ups, and duplicates at the front-end, RightPatient ensures that the accurate medical record is used across the care continuum, eliminating denied claims, boosting bottom lines, and enhancing patient safety in the process.

Hospitals Must Ensure Improved Patient Outcomes as COVID-19 Cases Spike

November 12, 2020/9833 views / 0 Comments/in BLOG, COVID-19, Data Integrity, healthcare, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

The moment everyone’s been dreading is almost upon us – another wave of COVID-19. This was inevitable, as most experts had stated that there would be a significant surge during this year’s fall season. According to experts, almost half of the US – including Alabama, Alaska, Colorado, Texas, Utah, and Washington – is facing rising cases. The CDC (The Centers for Disease Control and Prevention) Director previously stated that the fall might well be one of the worst times the US healthcare system will face. That being said, as hospitals are steeling themselves for the upcoming surge, they need all the help they can get to ensure improved patient outcomes. Let’s explore the CDC’s most recent findings, what the future might hold, some problems faced by caregivers during the first wave, and how RightPatient can enhance patient safety and mitigate known issues.

Some frightening statistics

According to the CDC, COVID-19 tests have been increasing across the US. As of now, Rhode Island, Vermont, Wyoming, Colorado, Minnesota, Kansas, Maine, Massachusetts, Nebraska, Connecticut, and Iowa are the states experiencing the fastest spread of the novel virus, according to rt.live. Unfortunately, that’s not all – it’s just the beginning.

On the 30th of October, the US hit a record high for daily COVID-19 cases with a staggering 99,155 cases. Moreover, the previous day had also held that record, as per The New York Times. 100,000 daily COVID-19 cases might soon become a reality. Public health officials also told The New York Times that positive rapid test results are being severely undercounted. To make things worse, it’s virtually impossible now to track the COVID-19 cases back to a single source.

With all that said, hospitals are preparing for the worst, and they need all the help they can get for improved patient outcomes – let’s take a look at what happened during the first wave.

Problems faced by healthcare providers

Tom Leary, HIMSS VP of Government Relations stated that incorrect patient data leads to a number of issues that hamper any public health response initiative. Delays in sharing COVID-19 test results, inaccurate information within patient records, and the lack of properly shared patient data were some consequences that could be traced back to an overlooked but critical problem of the US healthcare system: patient identification errors. Moreover, whenever a vaccine is created, its deployment will require immaculate patient identification in order to make it effective – which patients received the shot, which are still waiting for it, and what are the outcomes.

Among other problems, patient misidentification was quite prevalent during the initial COVID-19 wave, and it’s natural to assume that it will happen again. Moreover, when COVID-19 spikes become overwhelming, regular patients will once again resort to using telehealth.

Thus, if caregivers want to ensure improved patient outcomes, they not only need to ensure positive patient identification but also ensure patient safety during both inpatient visits and remote sessions. Fortunately, as previously mentioned, that’s where RightPatient can help.

RightPatient ensures improved patient outcomes

RightPatient is a touchless biometric patient identification solution that has been helping healthcare providers for years. It locks the medical records of the patients using their photos upon enrollment.

During appointment scheduling, patients receive an SMS or email requiring them to provide a personal photo as well as a photo of their driver’s license. RightPatient automatically matches the photos and verifies their identities remotely, ensuring accurate patient data right from the start for improved patient outcomes.

In healthcare facilities, patients only need to look at the camera – the platform matches the photo saved during enrollment with the live image. After verification, it provides the appropriate medical record within seconds – enhancing patient safety and ensuring infection prevention.

RightPatient protects patient data integrity, prevents duplicate medical records, and enhances healthcare outcomes by identifying patients accurately across the care continuum. Be a responsible caregiver and protect patients now with RightPatient.

Patient Data Accuracy is More Crucial Than Ever for Value-Based Care

November 11, 2020/9169 views / 0 Comments/in BLOG, Data Integrity, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety, value-based care /by Matt Gibson

While the US healthcare system, as well as the entire world, is still facing the effects of the COVID-19 pandemic, the former has several issues not directly associated with the novel virus. For instance, the lack of price transparency, increasing healthcare costs, healthcare data breaches, medical identity theft, the lack of interoperability, and the lack of effective patient identification in hospitals are just some of the many problems that plague healthcare providers. While we’ve already covered many of the aforementioned topics, today’s focus will be on value-based care, some upcoming adjustments, and why accurate patient data is crucial for it.

Value-based care in a nutshell

Value-based care is a frequently discussed topic within the healthcare space – it’s supposed to transform healthcare for everyone. While healthcare costs have been ever-increasing and accompanied by all-too-often poor healthcare outcomes, value-based care is thought to be the game-changer. Instead of focusing on the fee-for-service model, value-based care focuses on paying hospitals and physicians based on the patients’ health outcomes.

Due to value-based care, patients will experience lower costs and better healthcare outcomes, healthcare providers will experience better patient satisfaction scores and improved efficiencies, and everyone involved in the model will experience reduced costs and better overall results.

Value-based care has been heavily focusing on:

reducing price and providing transparency regarding it,
enhancing care quality by providing a competitive environment for caregivers,
pushing for enhanced interoperability to improve coordinated care.

However, value-based care will be focusing on more areas as it seeks to improve healthcare as a whole. Let’s take a look at some of the recent updates.

Some current updates regarding value-based care

Medicaid will finally be integrated into value-based care, according to Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS). Medicaid directors across the States have been sent letters including ideas that will help incorporate value-based incentives within programs. Moreover, CMS wants all public and private entities to participate alongside Medicare and Medicaid.

The Center for Medicare and Medicaid Innovation (CMMI) was established to test alternative payment models. It created fifty-four models; however, only five of them demonstrated savings, and only three of them are applicable for national expansion. CMS is hard at work observing the data in order to mitigate these issues.

Being flexible regarding regulations might do the trick, as the CMS believes that the exemptions introduced during the pandemic might be offered within the models for more participants.

There are many other proposed changes as well as those already underway, along with what might be the future of value-based care. A more detailed explanation can be found here.

However, even when value-based care was introduced, one thing was certain – accurate patient data is crucial for it to work. Let’s take a look at why patient data will make or break CMS reimbursements that focus on such models.

Accurate patient data is required for value-based care

Since the focus of value-based care is better healthcare outcomes, providers need to ensure that the right patient is receiving the right treatment at the right time. However, if patient data is inaccurate, it will significantly degenerate healthcare outcomes. For instance, if a patient is misidentified during registration, that patient will be treated using someone else’s medical record – someone with different diagnoses, test reports, ailments, allergies, and so on. If one takes previous patient misidentifications into account, both the misidentified patient, as well as the record holder, have faced adverse health outcomes. Thus, patient data integrity must be maintained to ensure that the information is consistent, accurate, and useful. That’s where RightPatient can help.

RightPatient enhances patient data integrity

Right from the beginning, RightPatient ensures accurate patient data by eliminating patient misidentification, avoiding duplicate medical records, and preventing medical identity theft.

It is a touchless patient identification platform used by several caregivers such as Community Medical Centers, Grady Health, MediSys Health, and Catholic Health of Long Island. By using patients’ faces, RightPatient locks the medical records upon registration with their photos. While scheduling appointments, patients only need to provide a personal photo along with a photo of their driver’s license – the platform automatically verifies the photos to ensure a proper match.

Within healthcare facilities, patients only need to look at the camera – the platform verifies the identities to see if the patients are who they say they are, preventing patient misidentification, avoiding duplicates, and maintaining patient data integrity as well. All these lead to better healthcare outcomes, something which is crucial for value-based care.

Choose RightPatient now and enhance healthcare outcomes by ensuring patient safety across the care continuum.

Patient Identifying Information Used Determines Patient Safety Within Hospitals

November 9, 2020/8033 views / 0 Comments/in BLOG, Duplicate Medical Records, healthcare, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Even before the COVID-19 pandemic hit the US, its healthcare system was plagued by a multitude of issues. Increasing costs, the lack of price transparency, medical identity theft, healthcare data breaches, duplicate medical records, and the lack of interoperability are just some of the many problems surrounding healthcare. While these are persistent issues, many of them took a backseat when COVID-19 struck the US – except for patient misidentification. During the pandemic, healthcare providers profoundly felt the lack of an effective patient identifier. It led to patient safety issues, result mix-ups, patient misinformation, and so on. Let’s explore what healthcare experts are doing, why a national patient identifier might not be enough on its own, and how patient identifying information used by a healthcare provider heavily influences patient safety.

The current state of patient identification

Patient identification has been a mess within the US healthcare system due to a number of factors. However, the biggest reason is that there is no standardized patient identifier that can be used to accurately identify patients’ medical records. As a result, many healthcare providers are still using the archaic process of finding electronic health records manually. Even though EHR systems provide search functionalities, issues such as common names and demographic characteristics as well as duplicate medical records make it harder to identify the accurate medical record. Thus, using names as patient identifying information is inefficient, dangerous, and, in high-stress environments such as registration desks of hospitals, might lead to misidentifications.

As a result, even this year, coalitions were formed where healthcare leaders came together to demand a state-funded UPI (Universal Patient Identifier) and expressed why accurate patient identification is crucial to ensure desirable healthcare outcomes. Back in July, healthcare leaders across the industry were relieved when the House of Representatives finally voted to overturn the ban on the UPI.

Its creation, though, depends on the Senate now; they must approve the policy change. While we are closer to a national patient identifier than we’ve been in years, the Senate didn’t approve of abolishing the ban last year, citing privacy concerns.

Why is patient identification so crucial?

Let’s take it from an expert, Tom Leary, HIMSS VP of Government Relations. During a session organized by the ONC (Office of the National Coordinator), Mr. Leary stated that incorrect patient data hampers public health response initiatives, such as those during the pandemic. As a result of patient identification errors, improper data sharing, delayed test results, and inaccuracies in medical records were seen during the crisis. Also, whenever the vaccine for COVID-19 is created, accurate patient identification is a must to deploy large-scale immunizations. While these were just some of the anomalies observed during the pandemic, patient identification errors have been rampant for years.

Hospitals using ineffective patient identifying information to identify proper medical records have been facing issues such as denied claims, patient safety issues, duplicate record creation, overlays, and poor care coordination across their facilities. With all that said, along with years of medical record errors, duplicates, and so on, will the UPI be enough on its own to eliminate all the existing issues?

Choosing the right patient identifying information won’t be enough for the UPI

Short answer: the UPI won’t be enough in the near future. First, creating a UPI will be quite expensive and time-consuming. In terms of implementation, it will take years to cover the entire population. Also, its efficacy will entirely rely on the patient identifying information used. For instance, many healthcare providers already use Social Security numbers, and they’ve proven to be ineffective identifiers. These numbers can be easily lost, stolen, or even forgotten by the patients, making them unreliable identifiers.

Thus, the only way to make the UPI a success is to couple it with an existing and robust patient identification platform, one that has experience ensuring positive patient identification. That’s where RightPatient comes in.

RightPatient uses the most practical patient identifying information

Many healthcare providers are using RightPatient as their patient identification platform, and they chose it for a number of reasons. One factor that sets RightPatient apart is it uses the one feature that cannot be stolen, forgotten, or misplaced as patient identifying information – patients’ faces.

After successfully scheduling an appointment, the patient receives an SMS or email requiring a personal photo as well as a photo of their driver’s license. RightPatient matches the photos to ensure remote patient authentication.

Within healthcare facilities, registered patients only need to look at the camera – the platform matches the photos and ensures accurate and touchless patient identification. This helps to provide a hygienic environment for both patients and registrars, eliminating infection control issues and enhancing patient safety.

RightPatient has years of experience ensuring accurate patient identification – try us now to learn how we can help you reduce denied claims, prevent duplicate records, improve healthcare outcomes, and more.

Healthcare Data Breach Cases Lead to Medical Identity Theft – How Are You Protecting Patients?

October 28, 2020/9324 views / 0 Comments/in BLOG, Cybersecurity, Data Breach, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Anyone who knows about the US healthcare system also knows that it has always been riddled with issues, even before the COVID-19 pandemic hit. Astronomical costs, the lack of price transparency, and the insurance system are not the only problems. Poor healthcare outcomes, preventable medical errors, medical identity theft, duplicate medical records, and lack of interoperability also plague healthcare facilities across all states. While we have covered many of these topics at one point or another, this time we will focus on healthcare data breach cases. Let’s take a closer look at recent healthcare data breaches, why providers are being targeted so frequently, how they generate medical identity theft, and how healthcare providers can protect patient data even after breaches.

Healthcare data breaches are becoming increasingly common

When the pandemic hit the US healthcare system, many hackers had pledged that they won’t attack healthcare providers and steal patient information – something that was unprecedented. However, not all of the hackers shared the same mindset, and there have been many healthcare data breach cases over the past few months. As a result, healthcare providers are having to fight multiple battles at the same time. Let’s review two of the recent attacks.

UHS reportedly suffered a huge breach

Pennsylvania-based Universal Health Services, a health system that consists of 26 hospitals, suffered a breach. On the 30th of September, they stated that some of the systems had been recovered. While there are no specifics as to how many patients were affected, the health system was forced to go offline on all of its locations to reduce the risks. However, it is working tirelessly to restore the affected systems.

Ashtabula County Medical Center

The Ohio-based medical center also suffered a cybersecurity attack on the 27th of September which forced it to cancel procedures.

What are healthcare providers saying regarding data breaches?

Many are stating that healthcare data breach cases are becoming quite common and they need better cybersecurity measures to reduce these unwanted events. While cybersecurity has always been a concern of CIOs and IT leaders, the budgets don’t allow them to realize their visions of having breach-free health systems. Moreover, they are expecting even more data breaches in the future, as they don’t see data breaches going away anytime soon. Sadly, the problems do not end here.

Healthcare data breaches generate medical identity theft

Data breaches are huge nightmares for any healthcare provider. The worst part is that they’re inevitable, and even the biggest health systems can be vulnerable – hackers are constantly uncovering new strategies to attack and steal patient information.

After stealing the patient information, fraudsters buy it from the black market and they assume the identities of the patients. Not many healthcare providers have effective patient identity management systems, so scammers can easily pass themselves off as the patients, since they have their credentials. If providers use effective patient identification platforms, they can prevent medical identity theft in real-time. Thus, while data breaches are inevitable and, without proper cybersecurity measures, unavoidable, medical identity theft can be prevented.

RightPatient mitigates the losses associated with data breaches

Using a robust photo-based engine, RightPatient ensures accurate patient identification using the feature fraudsters or hackers cannot steal or imitate: patients’ faces.

The platform can also identify patients right from appointment scheduling – patients are asked for a personal photo and a photo of their driver’s license after scheduling an appointment. After patients provide the photos, RightPatient matches the photos to verify the patient’s identity to see if they are who they say they are. If a fraudster is assuming the identity, RightPatient red-flags the anomaly, preventing medical identity theft in real-time. New patients are provided with biometric credentials, making it a seamless process.

If the patients are coming in person to the healthcare facilities, all they need to do is look at the camera. RightPatient matches the new photo with the saved one – if it’s a scammer, RightPatient red-flags the incident, preventing medical identity theft. It ensures a touchless and hygienic environment for everyone, something that is mandatory in a post-pandemic world.

RightPatient is enhancing patient safety, protecting patient data from being corrupted, and improving healthcare outcomes. Mitigate your losses, prevent medical identity theft, and enhance patient safety now with RightPatient.

Medical Identity Theft Prevention Becomes Crucial as Telehealth Usage Rises

October 23, 2020/9394 views / 0 Comments/in BLOG, Data Breach, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Outcomes, Patient Safety, Privacy, Telehealth /by Matt Gibson

The novel coronavirus, infamously known as COVID-19, is a phenomenon that has changed our lives forever. Wearing masks, using sanitizers, and practicing social distancing has become a part of our daily lives, especially for those who need to leave their houses every day. It has disrupted business operations and even forced many into bankruptcy, causing businesses to shut down. One of the most affected industries is healthcare, and it is safe to say that the US healthcare system has been severely affected by the pandemic. Hospitals have shut down, and those that are open are facing unprecedented losses. However, telehealth has experienced a meteoric rise in both popularity and usage. While more patients and caregivers are adopting telehealth, healthcare providers need to ensure that such visits are not plagued with medical identity theft cases. Let’s take a look at the rapid rise of telehealth, how people are adapting to it, and how medical identity theft prevention can be ensured with RightPatient.

Telehealth is becoming mainstream

Let’s take a look at a recent survey by Amwell. The research sheds light on the fact that patients and caregivers are far more open to using telehealth now compared to the pre-pandemic period. The numbers clearly illustrate this: in 2019, 8% of patients and 22% of caregivers had virtual sessions, whereas in 2020, the number is around 22% for patients and a whopping 80% for caregivers. This is predominantly because the pandemic forced hospitals to shift their focus to the COVID-19 patients, leaving others with the option to get treated via virtual sessions rather than inpatient visits.

Some of the key findings from the study regarding telehealth are:

More scheduled virtual visits compared to urgent care visits

According to the survey, patients leaned towards scheduled virtual visits compared to urgent care visits. 54% of patients had scheduled virtual visits with their physicians, whereas 21% of patients who had at least a virtual visit had an urgent care visit as well during 2020.

Virtual specialty care is growing rapidly

Unsurprisingly, telehealth is being used by more patients every day. 42% of patients had virtual visits with their regular specialists, and 13% had virtual visits with new specialists this year. Moreover, specialists such as cardiologists, surgeons, and others stated that they had seen more patients virtually compared to 2019. This led to specialists being more open to telehealth as well – it was the only way to treat some patients due to COVID-19.

More patients were opting for telehealth

2020 had three times the number of patients using telehealth compared to 2019. 59% of the patients who used telehealth stated that their first usage was during the pandemic, and an overwhelming 91% of the patients were “very” or “somewhat” satisfied with the visits.

Healthcare providers, on the other hand, said that they saw almost four times more patients this year compared to 2019, and 84% of providers were “very” or “somewhat” satisfied with the platforms.

Medical identity theft prevention must be ensured

While all of the above statistics show that telehealth has a promising future ahead, it also has to ensure patient safety. There are many risks associated with conventional inpatient visits such as medical identity theft, patient misidentification, medical errors, and so on. While not all of these issues will bleed over to telehealth, many experts are predicting that telehealth might witness medical identity theft cases. Thus, responsible caregivers should ensure medical identity theft prevention to secure safe, undisrupted healthcare visits – for both virtual and inpatient visits.

How data breaches, medical identity theft, and telehealth are related

Healthcare data breaches are becoming common because hackers can steal patient information and sell it for up to $1000. Data breaches are endless nightmares for healthcare providers – causing HIPAA compliance issues, loss of goodwill, unwanted publicity, and finally, medical identity theft. Fraudsters buy the information from the hackers to assume the identities of the patients and use the victims’ healthcare services illegally. Since many healthcare providers don’t have robust patient identity verification systems, they are unable to identify the scammers. These are the cases that occur within healthcare facilities.

Telehealth has been largely ignored in the pre-pandemic world. People were debating about its pros and cons, and since it didn’t provide the same level of flexibility as conventional healthcare, its future was uncertain. However, the pandemic changed the public’s perception regarding telehealth. As the statistics above demonstrated telehealth’s acceptance, experts have predicted that hackers and fraudsters will focus on it as well. If they acquire the login credentials of patients, fraudsters can also impersonate the victims during telehealth sessions, committing medical identity theft virtually. Thus, medical identity theft prevention becomes crucial.

RightPatient ensures medical identity theft prevention

Thankfully, healthcare providers can prevent medical identity theft with RightPatient. It is a touchless biometric patient identification platform that uses the faces of the patients to prevent healthcare fraud and protect patient data. With a powerful photo-based engine, RightPatient ensures that the patients are who they say they are. After scheduling appointments, patients receive an SMS or email and they need to provide a personal photo and a photo of their driver’s license to verify their identity. The platform automatically matches the photos, ensuring remote identity verification.

RightPatient ensures accurate patient identification across the continuum of care, starting right from appointment scheduling. During hospital visits, all the patient needs to do is look at the camera – the platform matches the current photo with the one saved during registration, creating a touchless, easy, and hygienic experience. RightPatient is preventing duplicate medical records, reducing claim denials, preventing medical identity theft, and enhancing patient safety for leading healthcare providers. Be a responsible provider and protect patient data with RightPatient now.

Patient Safety and Quality Improvement Can be Achieved with Positive Patient Identification

October 21, 2020/10177 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Infection Control, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Among the several issues faced by the US healthcare system, one of the more prominent is patient misidentification. We know this to be true because even during the coronavirus pandemic, experts have stated that patient matching issues were continuing. Moreover, coalitions were formed to demand the fabled “unique patient identifier” once again. But why do healthcare providers demand patient identifiers time and again? Let’s take a look at some statistics that show how serious the issue is, some consequences caused by the absence of effective patient identification, and how patient safety and quality improvement are related to it.

Patient identification issues are nothing new

The last decade has been a transition towards technology for the US healthcare system. Caregivers such as physician practices, hospitals, and health systems have made the jump from traditional paper medical records towards the more standard electronic health records (EHRs). However, as they did so, they saw the issues that occurred due to the absence of an effective patient identifier nationwide. One of the biggest challenges is matching patients to their accurate medical record whenever they arrive for healthcare services. Let’s review some recent statistics about how common misidentifications are.

Some stats to back it up

According to a study conducted by eHealth Initiative, approximately 38% of the respondents have suffered from an unwanted event caused by patient misidentification within the last 2 years. Many of these events are caused by duplicate medical records, and an overwhelming 66% of the respondents blame data entry errors that lead to duplicates. Moreover, 80% of the providers have dedicated FTEs (full-time employees) or third-party contractors to solve these issues. The biggest barriers to reducing poor patient matching were the lack of prioritization and the lack of technology. 32% of the caregivers stated that they had around 3-10% duplicates within their EHR systems. All of these statistics show that patient misidentification is growing and needs to be addressed by caregivers. Fortunately, many hospitals and health systems are already using touchless patient identification platforms like RightPatient to solve these issues, but more on that later. Let’s see how patient misidentification is a barrier to patient safety and quality improvement.

Patient misidentification hampers patient safety and quality improvement

While patient misidentification causes a lot of problems for any given caregiver and patient, let’s take a look at how it impacts patient safety, and in turn, healthcare quality.

Patient misidentification is closely related to duplicate medical records

Duplicates can lead to patient misidentification and vice versa. For instance, if a patient comes in and provides their nickname instead of the name on the medical record, the registrar won’t be able to accurately identify the medical record. Thus, after failing to find the record, a new one gets created, leading to another duplicate record within the EHR system.

Likewise, if there are many duplicates within the system against the same patient, there are high chances that all of them have incomplete and inconsistent information. This will lead to matching the patient to the improper medical record. Both of these scenarios will lead to incorrect procedures, adversely impacting patient safety.

Patient misidentification hampers patient data integrity

As previously stated, data entry errors are quite common during registration. Thus, if patients are associated with the wrong medical record, they will be treated based on someone else’s medical history, illnesses, allergies, and so on. One single pill can severely impact the patient’s health – one can imagine what would happen if the whole procedure was wrong! Such cases have led to delayed care, repeated lab tests, and compromised patient safety.

Patient misidentification leads to medical errors

Quite closely tied with the previous point, patient safety and quality improvement cannot be achieved if medical errors keep occurring. While medical errors happen for a variety of reasons, many are preventable, and as stated previously, 38% of the healthcare providers surveyed reported that they suffered from medical errors tied to patient misidentification. These errors could have easily been prevented had the caregivers used robust patient identity matching solutions.

Patient safety and quality improvement is achievable with RightPatient

Leading healthcare providers such as Catholic Health Services of Long Island, Terrebonne General Medical Center, Community Medical Centers, among others, have been using RightPatient and improving patient safety and quality of care. As the healthcare industry’s leading touchless patient identification platform, RightPatient has years of experience helping hospitals and health systems identify patients’ accurate medical records across the continuum of care. The platform uses patients’ photos to identify their accurate medical records, prevent medical identity theft, avoid duplicate records, and prevent medical errors – enhancing patient safety and ensuring a hygienic environment that will be crucial in a post-pandemic world.

3 Patient Safety Measures Hospitals Must Take in a Post-Pandemic World

October 14, 2020/10582 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Medical Identity Theft, Patient Data, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

COVID-19 has changed reality for us – it has changed the way we lead our lives. Sanitizers, masks, and social distancing have become quite integral parts of our daily lives now. Wherever we go, social distancing practices are encouraged for a safer environment. However, it has shaken the healthcare systems of the world to their core, especially that of the U.S. With the highest number of cases in the world (as of now), hospitals are slowly opening their doors for regular patients. Keeping that in mind, hospitals must take patient safety measures while they are opening to ensure that patients receive care in a safe and hygienic environment. Let’s take a look at some common steps hospitals can take to prevent patient safety issues.

Some insightful statistics

According to a survey by Sage Growth Partners, 24% of the respondents (healthcare professionals) believe that issues such as disparate EHRs and lack of actionable data at the point of care lead to patient safety issues.

Improving patient safety is also among the top three priorities of the respondents, besides delivering high-quality care and increasing efficiency and reducing costs – all of which can be done by ensuring accurate patient identification (more on that later).

Let’s explore what kind of patient safety measures will help hospitals enhance patient care.

Patient safety measures that can help enhance patient care

Planning everything well in advance

While many might think that everything is slowly returning to normal, it’s quite the opposite. Working from home is still being utilized by most organizations, social distancing is still being practiced, and wearing masks and sanitizing regularly are still highly encouraged.

Since hospitals are opening slowly, they should plan every step carefully along with contingencies while keeping worst-case scenarios in mind. Hospitals need to plan the opening days and rather than opening the whole facility at once, they should open in phases. This will help reduce the risk of any mass outbreaks of COVID-19 – managing a mass outbreak at a single location will be much easier than managing outbreaks at all the facilities.

Also, hospitals should decide at what capacity will they operate and the duration for that testing phase. If all goes well, they can slowly increase the capacity of patients they will be serving.

Finally, the inventory required for all of the above needs to be planned to ensure that the necessary materials are available at all times. For instance, PPE has become quite critical, and these should be ordered well in advance before the stock runs out within the facilities. Thus, instead of reordering the materials when they’re at 30%, they should be reordered at, say, 45% – these are essential materials, after all.

Enforce safety measures for everyone

It goes without saying that every individual must practice a minimum level of social distancing to help themselves and others stay safe from the novel coronavirus. Sadly, not everyone follows that. Thus, the hospitals must enforce that everyone within the facility must follow the social distancing rules to a T. Not only is this one of the most common patient safety measures, but it also enhances safety for the physicians, nurses, and every other healthcare staff.

Keep brightly colored posters in places where they will catch everyone’s attention. Place stickers on the floor with six feet between them to show where patients or caregivers must stand, especially in busy places like registration desks. Make sure that everyone is wearing masks and that sanitizers are available everywhere. Keeping the facilities hygienic is crucial to enhance patient safety.

Ensure accurate patient data

One of the most crucial factors that make or break patient safety is patient data, as the former is heavily reliant on the accuracy of patient data. Imagine this, if the patient is treated based on inaccurate patient data, they will face delayed or incorrect medications, leading to poor healthcare outcomes. One of the most common ways patient data gets corrupted is via duplicate records.

If a patient has multiple records, there are high chances that the registrar will select the one with inconsistent or fragmented data, leading to adverse outcomes. Thus, ensuring that patient data integrity is maintained at all times is crucial for improving patient safety. Fortunately, RightPatient does all that – and more.

RightPatient is the leading patient identification platform used by healthcare providers like Terrebonne General Medical Center, Grady Health, and Catholic Health of Long Island. With a robust photo-based engine, it ensures that the patients are identified accurately at all times across the care continuum, helping patient data integrity by avoiding duplicate medical records. Moreover, it ensures that the patients are who they say they are and not impostors, preventing medical identity theft in real-time.

Finally, a platform like RightPatient is critical in a post-pandemic world because it is entirely touchless. Thus, it helps caregivers and patients operate in a hygienic environment by preventing infection control issues.

Use RightPatient now and enhance patient safety at your facilities, prevent medical identity theft, and prevent duplicate medical records – enhancing patient data integrity along the way.

Patient Safety and Quality Can Be Improved by Preventing Duplicate Medical Records

October 12, 2020/9716 views / 0 Comments/in BLOG, Connected Health, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Matching /by Matt Gibson

Patient safety is one of the more integral aspects of any given healthcare system. It ensures that patients are getting the required treatment without any medical errors or harm, healthcare outcomes are optimal, and healthcare services are delivered to the highest possible standard. While those are the common aims, the reality is quite different in the U.S. healthcare system. It has always been inundated with a number of serious issues – healthcare data breaches, medical identity theft, patient identification issues, lack of price transparency, and duplicate medical records are just some of them. The root cause of many of the issues are duplicate medical records. While we already had a closer look at duplicate medical records and how it impacts revenue cycle optimization, let’s have a look at how preventing duplicates can lead to enhanced patient safety and quality, among other things.

How duplicates impact patient safety and quality of healthcare

In a previous article, we’ve already seen how medical record errors like duplicates and overlays are created and how they cause claim denials. Let’s see how they impact patient safety and quality of healthcare as well.

AHIMA’s Shannon Harris and Shannon H. Houser stated in an issue of the Journal of AHIMA that duplicates and overlays don’t only cause financial woes, but lead the physicians and healthcare staff to inadvertently causing medical errors. For instance, imagine that a single patient has duplicate medical records in a hospital’s EHR system. While treating the patient, the physician will see the duplicates but chooses the one that has obsolete information. Since the information is not updated, the treatment or medication might very well cause adverse effects. Such cases might even lead to transferring the patients for emergency treatments, leading to jeopardized patient outcomes.

That’s not the only way duplicate medical records impact patient safety and quality of healthcare – let’s look at the latter. When you have fragmented information within duplicate records, issues such as repeated lab tests and delays in treatment are quite common. Since the majority of the healthcare providers’ registration systems have ineffective patient identity matching techniques, the number of duplicates keeps on increasing, leading to patient safety issues, patient data corruption, and financial troubles in the form of denied claims.

How are hospitals addressing duplicates?

Sadly, rectifying duplicates and overlays are quite complex and a nightmare for any given healthcare provider. While most of the hospitals are trying to fix duplicates by reallocating their HIM resources and even dedicating some of their FTEs (full-time employees) to identify and rectify the erroneous records, unless they address the frontend issues (read: identify patients accurately), it will be a never-ending cycle. Patients will be misidentified, duplicates will be created, and FTEs will be assigned to fix them on the backend, taking up valuable time and resources.

So, can hospitals address these issues and prevent duplicate medical records on the frontend?

RightPatient enhances patient safety and quality of healthcare

As previously mentioned, if the patients are accurately identified during the registration process, duplicates can be prevented right from the beginning. That’s what we do best with our industry-leading patient identification platform. RightPatient, with its touchless design, ensures that patients are identified across the care continuum, starting from appointment scheduling. Patients only need to provide their selfies and a photo of their driver’s license when they schedule appointments. RightPatient matches the photos and makes sure that the accurate patient record is identified every time the patient accesses healthcare services, remotely or otherwise.

When the patients arrive at the hospital, all they need to do is look at the camera – RightPatient matches the saved photo and the real-time photo during the check-in process, preventing duplicates, eliminating denied claims, and enhancing patient safety. The best part of RightPatient is that the entire identification process is touchless, creating a safe environment for all involved in a post-COVID-19 world.

Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

October 9, 2020/10470 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, HIM, Medical Record Mix-ups, Patient Experience, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

Medical record errors such as duplicate medical records and overlays are issues that keep resurfacing time and again, especially when they lead to patient identification errors. We’ve already taken a closer look at duplicate medical records, how they are created, and how they impact patient safety. However, these are not the only problems medical record errors create. Another prominent issue is that duplicates jeopardize your revenue cycle optimization efforts by creating denied claims. Let’s take a look at exactly how that happens, how denied claims can take up your valuable resources, and how RightPatient can help combat duplicates and overlays, and in turn, optimize revenue cycle management.

How duplicates get created

To understand how duplicate medical records affect the revenue cycle, let’s take a brief look at how duplicates and overlays get created. These usually originate during the registration process, especially if the healthcare providers don’t have any effective patient identity verification system in place.

For instance, patients keep coming in and they need to be identified immediately so that they can be treated. This clearly shows that hospital registration desks are environments that are always hectic and staff is under pressure, more so for busy or larger hospitals. If you factor in outdated or ineffective patient identification platforms, duplicates are bound to occur, along with problems such as infection control issues that are associated with touch-based patient identification platforms.

Coming back to duplicates, the registrars have a very small window to identify the accurate medical records from an EHR system that might house thousands of records. Name changes, common names, misspellings, and nicknames only make matters worse. For instance, the medical record is saved under the name “Richard Grayson”, but the patient uses his nickname “Rick Grayson”. These are bound to create identification issues, and when the registrar can’t find the accurate record, they might end up creating a new one – leading to a duplicate record. Furthermore, existing duplicates will create more confusion for the registrars – AHIMA (The American Health Information Management Association) has stated that larger healthcare facilities have around 20% duplicates.

That’s how medical record errors usually begin, and while we’ve already talked about how it impacts patient safety, how exactly does it affect revenue cycle optimization and a hospital’s financial performance? Let’s analyze the issue.

How revenue cycle optimization is hampered by duplicates

According to a Black Book report, 33% of denied claims were caused by patient identification errors in 2017, costing the average healthcare provider $1.5 million and the entire U.S. healthcare system a whopping $6 billion per year. Let’s see how duplicates lead to denied claims that hamper the revenue cycle.

It’s quite straightforward – as duplicate medical records consist of incorrect, obsolete, fragmented, or incomplete information, these lead to coding and billing errors. Moreover, as duplicates hamper patient care, litigation costs regarding such cases are not unheard of. Not only do healthcare providers lose money, but they also lose their goodwill – these stories spread like wildfire, whenever they occur.

Coming back to duplicate records and revenue cycle, let’s take a look at how they are related. One of the more common places where denied claims occur due to duplicates is during surgical procedures, according to an article from HIM Briefings. Let’s use the example provided by Letha Stewart from QuadraMed within the article.

During the presurgery phase, the patient comes in and is registered as “Richard Grayson” and has the medical record number 111. As previously mentioned, common names lead to confusion among the registrars, and thus, without an effective patient identifier, the registrar couldn’t find the accurate medical record on the day of the surgery. As a result, a new record gets created under “Rick Grayson” with a different number, for instance, 222. When the insurance provider verifies the claims regarding this surgical procedure, it will notice the glaring discrepancy – there are different medical records involved for a single procedure. Moreover, the insurer most likely will use the patient record available at their end, and seeing that the records don’t match, the claim will be denied. While this is a simple but illuminating scenario, this is how most of the claim denials that stem from duplicate medical records occur. To sum it up, incorrect, fragmented, or incomplete patient data and discrepancies lead to denied claims that impact revenue cycle optimization efforts.

Providers dedicate FTEs for fixing medical record errors

Duplicate records and overlays need to be identified and fixed to prevent impediments to revenue cycle optimization. Most providers do that by dedicating their full-time employees (FTEs) from their HIM departments. While these activities are necessary, they also consume a significant amount of resources and time. According to Stewart, many providers dedicate around five FTEs to solve these issues. However, if providers don’t have an effective patient identifier in place, they cannot take the load off their FTEs and they’ll need to continue fixing these errors for quite some time, leading to lower productivity and higher costs. Given the current pandemic, providers need to mitigate costs as much as possible. That’s where RightPatient can help them.

RightPatient enhances revenue cycle optimization

As we’ve mentioned several times, going to the root of the issue, patient identification, is the best strategy. If you avoid duplicates and overlays at the frontend, you won’t have to deal with them later and face consequences like denied claims, allocating FTEs for fixing the issues, and higher costs. But how can RightPatient help with that?

RightPatient is the leading touchless biometric patient identification platform used by many providers to prevent duplicates. With its photo-based search engine, RightPatient identifies patients from appointment scheduling and beyond. Be it remote patient validation or identification within the healthcare facility, RightPatient ensures that the correct medical record is provided every time within seconds. Reduce denied claims, prevent duplicates, and enhance patient safety with RightPatient now.